Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 13/01/09 for Allonsfield House Care Home

Also see our care home review for Allonsfield House Care Home for more information

This inspection was carried out on 13th January 2009.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Allonsfield House Care Home Allonsfield House Allonsfield House Care Home Campsea Ashe Woodbridge Suffolk IP13 0PX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tina Burns     Date: 1 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Allonsfield House Care Home Allonsfield House Care Home Allonsfield House Campsea Ashe Woodbridge Suffolk IP13 0PX 01728747095 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): jill@kingsleycarehomes.com Kingsley Care Homes Ltd Name of registered manager (if applicable) Jill Harris Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Allonsfield House, situated in Campsea Ashe, is registered to provide care for 41 people aged over 65 years, including nineteen people with dementia. The home is owned by Kingsley Care Homes, who took over the running of the home in December 2004. Campsea Ashe is a small village in a rural location, close to the town of Woodbridge. The home is located opposite the village church and 400 metres from the local train station, which has direct trains to Lowestoft, Ipswich and London. Woodbridge offers a range of amenities that include, restaurants, garden centres, shops, a Library, banks, Care Homes for Older People Page 4 of 30 care home 41 Over 65 19 23 0 0 Brief description of the care home a post office, Riverside Theatre and swimming pool. The home, a former farmhouse, has been refurbished and adapted over the years. In December 2006 a large extension to the home was also completed enabling the home to increase its registered numbers from to 23 to 41. The main house is located on two floors and accommodates up to 23 older people, including one named person with dementia. The extension provides ground floor, purpose built accommodation for up to 18 older people with dementia, and this unit is called Ashefiled. The home has appropriate communal areas throughout the home including dining, lounge and comfortable quiet areas. There are also safe, enclosed and attractive grounds to the rear & side of the premises and a visitors cark park. The Service User Guide tells us that fees currently start at £575.00 depending upon accommodation and care required. Newspapers and magazines, toiletries, clothes and dry cleaning are not included in the fee, nor are hair dressing, private chiropody, or opticians services. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection which focused on the core standards relating to older people, the report has been written using accumulated evidence gained prior to and during the inspection. The homes manager, Jill Harris was at the home at the time of our visit. She was fully co-operative with the inspection process and provided all requested information promptly and in an open manner. During our visit we looked around both units and made observations throughout the day. We also spoke with several residents and staff and a visiting relative. Documents we looked at included three residents care plans, three staff files and a range of health and safety and maintenance records. Care Homes for Older People Page 6 of 30 Information was also provided in the homes Annual Quality Assurance Assessment that was completed by the registered manager and submitted to us in August 2008. We asked the home to distribute have your say surveys to ten residents, ten staff, ten relatives and five health care professionals so that we could gain their views, however we received a total of just four completed surveys from relatives and two from staff. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 30 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents can expect to be provided with the information they need to make an informed choice about where they live. Evidence: The homes certificate of registration was on display in the foyer and there was a wide range of information on notice boards throughout the home. The Service User Guide and Statement of Purpose had been updated since the last inspection and included details about the terms and conditions and fees charged. The manager confirmed that the two conditions on the homes certificate no longer applied as the people concerned were no longer resident. They agreed to inform the Commission in writing so that the certificate could be appropriately amended. People that were spoken with and records examined confirmed that prospective residents have an assessment of their needs completed prior to moving into the home. Care Homes for Older People Page 11 of 30 Evidence: Assessments covered a wide range of needs and included areas such as moving and handling, nutrition and personal risks. The assessment completed for one resident with dementia that had recently moved into the home was not very detailed but there was evidence that it was being developed on an ongoing basis to include a fuller picture of their needs, likes, dislikes, interests and preferences. The manager explained that a life story book was also in the process of being completed in consultation with their family. The Annual Quality Assurance Assessment (AQAA) tells us that prospective residents are encouraged to come and look around the home and spend a day there to see what it is like. They are then offered a trial period so they can see whether it is suitable and the home can meet their needs. The home does not provide intermediate care. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can expect to have their health and personal care needs met. The principles of respect, dignity and privacy are put into practice. Evidence: Three of the four relatives who completed surveys told us that they felt the home sometimes meets the needs of their relatives and one said the home usually meets their needs. All four surveys said that the home sometimes gives the support or care that they expect or agreed. Comments we received were varied and some people told us they received more positives outcomes than others, for example; If needs equals basic care, a roof over their head and food then yes needs are met, Care is very basic and restricted to essential help such as medical attention and personal washing, Clothes are often unkempt and unclean, hair rarely brushed properly and sometimes the wrong clothes are in the wrong wardrobes, The problem is the level of detail and the attentiveness of staff, They are mainly very good, They are very caring and they do listen but I do have to mention things and Care Homes for Older People Page 13 of 30 Evidence: sometimes I have to say it more than once and The staff are very good. Comments included in the homes quality assurance report were more positive and included; We are always kept up to date about any problems or health issues arising, Overall the care provided is second to none, The staff show great warmth to my relative,Very pleased, my relative is treated with dignity and courtesy and as an individual, They do everything well, Look after me really well and General standards of care are good. Records examined included care plans that reflected the needs identified in peoples assessments. Discussion with the manager and information provided in the AQAA tells us that the home intends to improve the detail and quality of peoples care plans so that residents have a more person centred or individualised approach to their care. Life story books were being completed so that care staff could have a better understanding of peoples needs, backgrounds, preferences and interests. People we spoke with told us that care was provided with sensitivity and their privacy and dignity was respected. We observed staff interacting very positively with residents and they were polite and respectful at all times. Personal care was provided in private and behind closed doors. Staff were observed knocking on peoples bedroom doors before entering. One relative told us that their relatives dignity was sometimes compromised because they were not appropriately supported with their incontinence or provided with attention in a timely manner when staff are busy. On the day of inspection there was no evidence that anyone was left waiting for attention and the negative views expressed by some of the relatives were not supported by any other evidence. Staff spoken with said that they are often very busy and have to prioritise, they would like more time to assist people with their personal care so that they dont have to rush but they felt that residents were not usually left waiting unreasonably and their needs were not compromised. One said We have a routine and it usually works. The homes complaints records tells us that since the last inspection they have received one complaint about poor personal care and the lack of assistance provided to one resident. The complaint was investigated and it was evident that an apology had been given. Records seen during the inspection confirmed that the home works in partnership with Care Homes for Older People Page 14 of 30 Evidence: a range of health care providers so that residents health care needs are met, for example GPS and district nurses. Three out of four relatives that completed surveys told us that the home always keeps them up to date about important issues (such as health care matters) and one said that they sometimes keep them up to date. The home had appropriate policies and procedures in place for the safe administration and handling of medication. One member of staff from each unit was observed administering lunch time medication. They had a clear knowledge of the homes procedures and confirmed that they had undertaken training in this area. This was confirmed in the training records examined. The home used a monitored dosage system and medication was removed from the blister pack directly into a small pot which was given to the resident. The Medication Administration Records (MAR charts) that were looked at had been appropriately completed, there were no gaps identified and staff administering the medication had signed with their initials. There was also appropriate use of codes to identify if medication had been refused or not taken for any reason. The MAR charts included photographs of each resident who has prescribed medication. There was also good evidence that the home undertakes regular medication audits as part of their quality assurance processes. The Staffing section of this report looks at staffing levels and whether they have an impact on the quality of care at this home. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to maintain contact with their families and friends, participate in recreational activities of their choice and have healthy and appetising meals. Evidence: Feedback from relatives questionnaires indicated that the home is not good at helping their family members to keep in touch with them but observations during our visit and people we spoke with on the day confirmed that visitors are made welcome at the home. Some of the staff we spoke with were clearly familiar with and knew some of the relatives well. Further more friends and relatives have the option of having a copy of the homes monthly newsletter sent directly to them and social events are arranged that encourage relatives to participate. The AQQA tells us that they have an open house policy so that visitors can visit at their preferred times. There was also evidence that relatives are involved in assessment and care planning processes, Quality Assurance reviews and care plan reviews. Relatives questionnaires told us that activities at the home are very limited and provided by care staff that are not suitably skilled or able to dedicate sufficient time. Care Homes for Older People Page 16 of 30 Evidence: Consequently when we visited it was very positive to find that the home has appointed a full time, dedicated activities co-ordinator. It was also positive to see that residents meetings included agenda items such as activities and entertainment and this enabled people to have a voice about the activities on offer. Discussion with the activities coordinator indicated that they were highly motivated and keen to provide a good programme of one to one and group activities. They told us that they had not undertaken any training in dementia care but they were about to start a course to gain a level 2 certificate in the provision of activities in a care setting. At the time of our visit staff and residents told us that they were already having a very positive impact. One resident told us that they were going to the cinema later in the week. Others had been to see a musical and a pantomime. In addition more traditional activities such as bingo, board games and film sessions were taking place, as well as quizzes, art and craft sessions and hair and nail sessions. The home also had someone come to the home twice a week to run a memory clinic and provide armchair exercises. The Ashefeld unit had a white board in the corridor so that staff could write the day and date on it and provide information such as the names of the staff on duty, the menu for the day, activities on offer and any special information such as if it is some ones birthday. This is one way of assisting people with memory loss. However, on the day of the our visit the information was two days out of date and potentially likely to cause confusion. When this was pointed out to a care worker they changed it straight away. Residents could meet with their visitors in communal areas of the home or in the privacy of their own bedrooms. All residents had their own bedrooms, with the exception of one married couple who shared. Bedrooms seen were very personalised and confirmed that residents were able to bring some of their own possessions and personal effects with them when they moved into the home. Each unit had their own dining area and residents could eat in there or in the privacy of their own room. Food was provided by dedicated kitchen staff and care staff were not relied upon to cook, prepare meals or wash up. There was a four week rolling menu that had been devised by the cook. People were able to select from two main options at the time of the meal. On the day of our visit the lunch time meal was oxtail soup or advocado salad followed by fishcakes or veg curry and then pineapple upside down cake or fruit salad. There was also soft drinks available, red or white wine and after dinner tea or coffee. In Allonsfield unit everyone used the dining area except for six people who had their meals in their rooms. The dining room was pleasant and comfortable. Each table was laid with a table cloth, placemats, cutlery, glasses and napkins. No body required full Care Homes for Older People Page 17 of 30 Evidence: assistance but two people were provided with soft meals that were appropriate for their special dietary needs. The atmosphere was pleasant and sociable and the meal looked healthy and appeatising. In the Ashefield unit the same meal was provided but the environment was less congenial and the tables were laid with plastic coated table cloths and plastic glasses. The glasses were smeared with water marks which made them look grubby. Several people in the dining area were confused and needed some assistance or attention but it was difficult for the three care staff on duty in the unit to dish up the food, serve it and attend to peoples needs. Staff did interact positively with residents but they could not see to everyones needs at once. Consequently the mealtime was less relaxed and a little chaotic. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can expect to be safeguarded from abuse, further more the home has shown us that they have listened to and acted on compliants. Evidence: The homes complaints procedure was on display and provided clear information about how to make a complaint. The AQAA told us All complaints and concerns are listened to and acted upon quickly. Open door policy for all individuals and relatives to discuss concerns and any questions they may have. All complaints and concerns are documented. Relatives completing surveys confirmed that they knew how to complain. Three said that their concerns were sometimes responded to appropriately and one said that they were usually responded to appropriately. One relative was critical of a response of a senior manager and another said that they were able to raise concerns but nothing is done. Information provided in the AQAA, discussion with the manager and records examined confirmed that there had been five formal complaints made since the last inspection. Complaints records were in place but they did not, in all cases, clearly document how they had been dealt with or what the outcome had been. The manager agreed to make records clearer so that complaints can be more easily tracked to see if they have been Care Homes for Older People Page 19 of 30 Evidence: appropriately addressed. The records we saw did confirm that all five complaints had been handled by the manager or the companys Compliance and Quality Assurance Director. Records we looked at and discussion with the manager told us that although the concerns of one relative had been addressed they had not been satisfied with the way the matter had been handled and they felt that the health and safety of their relative had been compromised. However, complaints that followed about the care provided to one resident and the cleanliness of the home had been taken seriously and were instrumental in changes to staffing structures and roles within the home. Comments from people we spoke with on the day of our visit confirmed that the manager and staff are approachable and people felt able to raise their concerns. Information we received tells us that the home has made one safeguarding referral since the last inspection following an assault on one resident by another resident. The local authority involved told us that they were satisfied that the home had handled the matter appropriately and taken appropriate action to prevent further incidents. Records seen and feedback from staff told us that they had received safeguarding adults training. Discussion with the manager confirmed that some staff had been trained to deal with challenging behaviour and further training was planned for staff that had been employed since that time. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can expect to live in a safe and comfortable environment that meets their needs. Evidence: Ashefield unit has the capacity to accommodate eighteen older people with dementia and has been built with their specialist needs in mind. At the time of our visit there were seventeen people living in the Ashefield unit. Communal areas included two lounges, a dining room and a large sun lounge although the small lounge and sun lounge was not significantly used at the time of our visit. Instead we observed everyone sitting in the main lounge area which was just big enough to take enough chairs for the residents and consequently felt a little over crowded. We asked care staff whether people normally congregated in the main lounge and they told us that it was where the residents prefered to be. All bedrooms in the Ashefield unit had en-suite facilities consisting of a shower, wash hand basin and WC. Communal areas in the main house consisted of a main lounge, a dining area, a conservatory/sun lounge and some smaller, more private seating areas. With the exception of one bedroom that was shared by a married couple all rooms were single and had en-suite facilities. In the Allonsfield unit people were observed using communal spaces of their choice while others remained in their private rooms. Care Homes for Older People Page 21 of 30 Evidence: The manager confirmed that they had a maintenance worker who was usually based at the home four days a week and they felt that this helped them to keep up to date with the general maintenance , upkeep and decor of the home. On the day of our visit most of the home looked in good decorative order and was well maintained with the exception of a few small areas of peeling paint that the manager agreed to deal with. It was also evident that the lounge carpet in Ashefield was badly stained and one area in each unit smelled strongly of urine. The manager advised that they were in the process of ordering a new lounge carpet and having been unsuccessful in their attempts to get rid of the odours through deep cleaning methods they advised that they would ensure the relevant areas of flooring were replaced. Discussion with the manager and complaints records seen told us that since the last inspection there had been several concerns about the standards of cleanliness throughout the home. The manager explained that as a result they had employed a housekeeper who was responsible for the supervison of two domestic staff. She was confident that this had resulted in an improvement in standards and with the exception of the odours refered to previously we found the areas we saw clean and tidy. Hot water was supplied to the two sinks that we found without hot water at our last visit. There were suitable laundry facilities including commercial washing machines with automatic sluice facilities and commercial dryers. Staff were provided with disposable gloves and aprons and universal infection control procedures were applied. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the homes recruitment procedures but they cannot be certain that they will always receive a flexible, person centred service. Evidence: Three staff recruitment records were examined and included all documentation required including photographs, evidence of ID, CRB checks, application forms, references and health checks. On the day of inspection there were seventeen people resident in Ashefield and twenty people resident in Allonsfield House. Three care staff were on duty in each unit and we were told that was the usual ratio of staff. The manager is supernumerary and there is a full time activities co-ordinator. There is also a team of anciliary staff that includes two cooks, one housekeeper, two domestics and a maintenance worker. Three out of four relatives that completed surveys told us that the home meets the needs of their relatives sometimes and one said usually. Four out of four relatives said that their relatives are sometimes supported to live the life they chose and four out of four said the home sometimes gives the support or care to their relative that they would expect. Their comments included; Care Homes for Older People Page 23 of 30 Evidence: Individual staff members are attentive and caring but there is insufficient time for stimulation..., Very little attention to detail even though those detailed needs are noted in the care plan, Care is very basic and restricted to essential help such as medical attention and personal washing..., Staff do not appear to have the time..., ...the problem is the level of detail and the attentiveness of staff. They appear overworked (or understaffed) and If they do have the skills they lack the time to put them into practice. During our visit we observed that staff interacted with people positively and with respect. Residents personal care needs seemed to be met and we could not see anyone waiting unreasonable amounts of time for assistance with their personal care. However, staff were very busy and they agreed that they sometimes found it difficult to provide people with enough attention to provide individualised person centred care. This was particularly evident at lunch time on Ashefield unit. We asked care staff whether they thought that staffing levels were adequate and met peoples needs. Of the two that completed surveys one said usually and the other said sometimes. Comments we received from staff during our visit included; We could give more with one more (staff per shift), Staff are being rushed, not esidents, Would like more opportunity to talk with them at other times, not just when providing their personal care, Peoples needs are higher, they are needing more assistance. Dont have time to stop and chat.....they dont realise we are rushing them and We do find that with three of us we have a routine and it usually works. We spoke with the manager about staffing levels and asked them how they ensure that staffing levels are adequate. They told us that the company assesses staffing levels by using Department of Health guidelines. This can be very helpful but is not suitably sufficient to confirm that staffing levels are adequate. The manager agreed to ensure that other ways of evaluating staffing levels are introduced, such as gathering feedback from residents, relatives and staff and undertaking direct observations particularly at peak times such as meal times. Unfortunately the activities co-ordinator had only been employed recently and it was too early for people to see any real benefit. However, care staff did agree that the co-ordinator had relieved some pressure from them as they had previously been relied upon to provide activities. Information provided in the AQAA tells us that over fifty percent of care staff have NVQ level 2 qualifications or above. Information provided by the manager, feedback from staff and records seen also tell us that the home provides appropriate induction and ongoing staff training including manual handling, relevant health and safety training and protection of vulnerable adults. Some staff that were working in the Ashefield unit told us that they Care Homes for Older People Page 24 of 30 Evidence: had not undertaken any training in dementia care but the manager has assured us that dementia care training is planned for all staff and they themselves are booked on a course with Bradford university in June 2009 so that they are fully trained to deliver dementia training. Care Homes for Older People Page 25 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can expect to benefit from a more responsive style of management. Further more the health, safety and welfare of staff and residents are promoted and protected. Evidence: Since the last inspection the manager, Jill Harris had had her registered managers application approved by the Commission. She has worked in the care sector for several years and has the NVQ 4 registered managers award. The manager was receptive to the inspection process and welcomed feedback and discussions about how the home could improve. The manager advised that since the last inspection the homes staffing structure has changed. Instead of a deputy homes manager each unit now has a team leader. The manager advised that they felt this provided a more effective approach to the day to day running of each unit, the supervision of staff and the monitoring of care practices. Care Homes for Older People Page 26 of 30 Evidence: The manager completed the AQAA when we requested it. It included some useful information but overall it was not very detailed and did not fully evidence what they do well and where they can improve in all the outcome groups. It did provide us with the following information about their internal quality assurance processes; We send out questionnaires to residents and families from these we gather the information, residents meetings, talking to residents, information the carers pass on We have made the following changes as a result of listening to people who use our services: changes to menus, changes to the outing this year, regular residents meetings, pond area improved, new garden furniture We are planning to make these further changes as a result of listening to people who use our services: We are looking to purchase a rabbit for Ashefield, also the residents in Allonsfield have requested a larger television in a more central position....Looking to create a better activities programme and employing an activities co-ordinator. Discussion with the manager confirmed that it is still the homes policy not to handle residents monies. Residents that are not able to manage their own finances are supported by their relatives or representatives. Residents are invoiced on a monthly basis for items, such as newspapers and toiletries that are supplied by the home but not included in the fees. Staff training records evidenced that staff had been provided with health and safety related training such as manual handling, food hygiene, first aid, COSHH (control of substances hazardous to health) and fire safety. Health and safety checks were in place to ensure the environment was safe, for example fire alarm tests, fire extinguisher tests, emergency lighting tests, hot water temperature checks and manual handling equipment checks. Care Homes for Older People Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 28 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 15 The home should look at ways of improving experiences for people in the Ashefield unit at lunch time. Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!